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Updates & News: Regulatory

PEPPERs Available - HHAs and Hospices

Saturday, September 2, 2017  
Posted by: Kate Gagne
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I work for TMF Health Quality Institute which is contracted with the Centers for Medicare & Medicaid Services to develop, produce and disseminate provider-specific comparative data reports, referred to as the Program for Evaluating Payment Patterns Electronic Report, or PEPPER.  PEPPER summarizes one provider’s Medicare claims data statistics for areas that have been identified as at higher risk for improper Medicare payments.  Providers can consider their statistics and whether they should take any action, such as reviewing a sample of records to ensure care provided was necessary and that documentation supports the diagnosis and procedure codes that were billed.
PEPPER has been available to home health agencies since July of 2015, and to hospices since 2012.  We would like to encourage providers to access this free comparative billing report and utilize it as a tool to support their auditing and monitoring efforts.  With that in mind, would you consider sharing the attached item, via e-mail or newsletter? 
Please note that the PEPPER team has developed maps that display the PEPPER retrieval rate for PEPPERs accessed via the PEPPER Resources Portal for each state/territory.  States on the interactive map are color-coded according to their retrieval rates.  Users can click on a state to obtain details such as the number of PEPPERs available in the state via the portal, the number of PEPPERs accessed via the portal, the retrieval rate, and a link to the data file for all states/territories in the nation.
Map of Hospice PEPPER Retrievals by State                                       
If you have any questions, please feel free to contact me.  
Cindy Hunter, M.Ed., CCM, HACP, CPHQ
Health Services Consultant II
TMF Health Quality Institute
Bridgepoint I, Suite 300
5918 W. Courtyard Drive
Austin, TX   78730-5036
(512) 334-1732
TMF Health Quality Institute focuses on promoting quality healthcare through contracts with federal, state, and local governments, as well as private organizations.  TMF does not accept liability for any error or omissions in the contents of this message which arise as a result of e-mail transmission.  This communication, including any attachments, may contain confidential information and is intended only for the individual or entity to which it is addressed.  Any review, dissemination, or copying of this communication by anyone other than the intended recipient is strictly prohibited.  If you are not the intended recipient, please contact the sender by reply e-mail and delete and destroy all copies of the 

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